Provider Demographics
NPI:1467879536
Name:CENTER FOR SEDATION AND ORAL REHABILITATION
Entity Type:Organization
Organization Name:CENTER FOR SEDATION AND ORAL REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:NAHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:YANNI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-254-0033
Mailing Address - Street 1:385 CRANBURY RD
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3000
Mailing Address - Country:US
Mailing Address - Phone:732-254-0033
Mailing Address - Fax:732-238-8869
Practice Address - Street 1:385 CRANBURY RD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3000
Practice Address - Country:US
Practice Address - Phone:732-254-0033
Practice Address - Fax:732-238-8869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI22082001223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty